Boys Run Club

1.	Student's Name*

2.	Student's Birthdate*

3.	Student's Age*

4.	Student's current teacher*

5.	Parent/Guardian Name*

6.	Parent/Guardian phone*

7.	Parent/Guardian email*

8.	Street Address*

9.	Emergency Contact Name and Phone*

10.	Please list any health issues:

	**It costs $50/child to join the Boys Run Club. You can bring cash only on the first day of practice or pay through the PTO online store, located on the side navigation bar of the PTO website.

11.	I give permission to the Boys Run Club to use my child's image in any photograph or video to promote the team.
	I give permission to the Boys Run Club to use my child's image in any photograph or video to promote the team. YesNo

12.	I will read and sign the liability waiver (please refer to the link that is provided AFTER you click "save" below)
	I will read and sign the liability waiver (please refer to the link that is provided AFTER you click "save" below) YesNo